Family Medicine Napa/Solano - Curriculum & Rotation Schedule

Our inpatient service trains residents to not only become knowledgeable in acute patient care skills, but also in leadership and supervisory skills. Family Medicine Inpatient Service highlights include:

• Team of two PGY-1s, one PGY-2, and one PGY-3, supervised by family medicine and hospitalist faculty
• A census of 10-15 patients
• Clinical Teaching Skills courses for PGY-2s and PGY-3 residents
• Morning rounds and procedures supervision by senior residents

Our pediatrics curriculum is taught by both family medicine faculty and pediatricians from both the Vallejo and Oakland Medical Centers. The curriculum consists of:

• 8-weeks in the Kaiser Vallejo pediatric outpatient clinic with time in the Emergency Department seeing pediatric patients
• 4-weeks in the newborn and intermediate care nursery at Kaiser Vallejo, where family physicians and pediatricians teach examination of newborns, newborn illnesses, breast-feeding, maternal and paternal education, circumcision, resuscitation and stabilization at deliveries
• 8 weeks of inpatient pediatrics at the Kaiser Medical Center in Oakland as a member of the inpatient resident service
• Caring for pediatric patients in the resident’s own continuity clinic in the Family Medicine Center, with a robust pediatric patient population (resident patient panel are 35-40% pediatrics)

Residents practice women’s health in both the OB-Gyn department and their own continuity clinics. Highlights include:

• Dedicated time on Labor and Delivery caring for and delivering patients admitted for labor under the supervision by family medicine faculty, obstetricians, and certified nurse midwives
• An elective experience in advanced and high risk obstetrics
• Dedicated time in the women’s health department seeing gynecologic issues
• Caring for prenatal patients in the resident’s own continuity clinic in the family medicine center
• Procedural training in common GYN procedures such as Pap smears, colposcopy, endometrial biopsy, IUD placement, sub-dermal contraceptive implants, and KOH prep
• Comprehensive Family Planning Training including miscarriage management, medical abortions, D&Cs, and opportunities for advanced training

The Kaiser-Permanente Napa-Solano Family Medicine Residency Program created an Obstetrics Distinction to acknowledge the dedication of residents who plan to incorporate full spectrum obstetrics into their future practice. The goal of this distinction is to recognize additional labor and delivery time and to provide extra opportunities for leadership in our Obstetrics Curriculum above and beyond our basic requirements of 40 deliveries and 10 continuity deliveries (please note that this is the requirement but baseline delivery numbers are much higher than this and will not change with this distinction). Residents who participate in the Obstetrics Distinction graduate with an anticipated 80+ vaginal deliveries, competency as a cesarean section first assist, opportunities for primary cesarean section exposure, and the opportunity to become certified Advanced Life Support in Obstetrics (ALSO) instructors. They take on additional teaching roles and curricular development. Commitment to the Obstetrics Distinction is expected prior to completion of intern year.

We are proud to share the news that, once again, the maternity services we provide our patients in the Napa-Solano area is being lauded on a national stage. Last week, Newsweek magazine named both Vacaville and Vallejo Medical Centers as being among the top hospitals in the nation for excellence in maternity care in its annual “Best Maternity Hospitals” report.

We join 10 other Northern California KP Medical Centers to earn this designation for providing safe, high-quality care to moms and their new babies. This is the second consecutive year we have been recognized for meeting rigorous standards for maternity care, including low C-section rates, elective early deliveries and for following important protocols to safely protect new moms and their babies. In all, only 34 hospitals in the entire state of California earned this designation.

Last year, our highly-skilled maternity services teams delivered nearly 3,000 babies , meeting or exceeding rigorous quality and safety standards put in place to give moms and babies the best care possible. The team has been a leader in providing innovative approaches to maternal care, including our Supporting Vaginal Birth Program that resulted in marked decreases in cesarean birth for first-time moms, and the Enhanced Recovery After Surgery Program, which helps new mothers recover more quickly after delivering by cesarean section with enhanced early mobility and improved pain control minimizing the use of narcotics. Our focus on breastfeeding is also integral to Kaiser Permanente’s maternity care, which has proven health benefits for both baby and mom.

For more detail on methodology and a complete list of designated maternity care programs, visit Newsweek’s “Best Maternity Hospitals 2021.”

We are incredibly proud of this recognition and the commitment by our physicians and staff who help ensure that our parents and their babies receive the highest standard in maternity care, especially during a pandemic.

Residents focus on inpatient surgery during the PGY-1 year, outpatient surgery during the PGY-2 year, and surgical subspecialties during the PGY-3 year. Residents will learn:

• Pre-operative, peri-operative, and post-operative care supervised by our surgeons
• Skills needed as a first assistant
• Outpatient procedures such as field blocks; laceration repair; skin biopsies; cryosurgery; removal of warts, skin tags, toenails, and foreign bodies; and incision and drainage of abscesses
• Common problems in Urology, Head and Neck Surgery, and Ophthalmology under the supervision of our surgical subspecialists

Behavioral Science and Mental Health is taught longitudinally throughout the three years of residency training by a team that includes a psychiatrist and a psychologist. Curriculum highlights include:

• Afternoons in the family medicine Behavioral Medicine Clinic
• A Behavioral Medicine Specialist who practices and is present in the family medicine department
• Dedicated time in the Chemical Dependency Recovery Program (CDRP).
• Regular Balint groups
• Lectures on topics in behavioral medicine

Our program’s mission is to provide outstanding training in community health and the care of vulnerable populations. The community medicine curriculum provides residents with a full spectrum of experiences:

• Continuity clinics every 6 weeks at our affiliated community clinic, La Clinica de la Raza, a Federally Qualified Health Center.
• Service-based learning at diverse community sites such as school clinics, domestic violence shelters, homeless resource centers, mobile health clinics, the public health department, WIC, the Vallejo Police Department, community gardens, health fairs, and free community clinics.
• Focused time in the first and third years to deepen and broaden community medicine training during two-week Community Medicine rotations.
• Cross-disciplinary learning with the global health curriculum, including lectures and opportunity for funded travel to Global Health sites.
• Didactics from faculty and community partners on needs assessments, designing and evaluating interventions, social determinants of health, grant writing, and budgeting. These are supplemented by multimedia learning through STFM and Duke community medicine modules.
• Required scholarly project implementing a school-based community health intervention. As part of the community medicine curriculum, residents will receive resources and training needed to design and implement a community intervention, as well as be paired with mentors and advisors for the duration of the project, including support from our staff epidemiologist.
• Opportunity to pursue an IRB-approved research for publication or presentation at national and regional conferences.

Residents rotate in the intensive care unit for four weeks during the second postgraduate year, working one-on-one with an intensivist managing their own ICU patients.

The dermatology curriculum has several components including longitudinal integration into the FMC and a two-week clinical rotation under the supervision of our staff dermatologists, seeing a large volume of both common and uncommon dermatologic problems. Residents will learn the lexicon of dermatology, identification of common as well as dangerous skin lesions and dermatologic manifestations of systemic disease along with procedural competency to perform common office-based dermatologic procedures.

Residents are taught the comprehensive care of elderly patients, learning how to address complex medical problems, psychosocial and family issues, nutrition and functional status, preventive health needs, and changes associated with the normal aging process:

• Dedicated geriatric rotation working with hospice, palliative care, wound care, dementia clinic, and geriatric psychiatry
• Caring for continuity patients at a Skilled Nursing Facility with our staff geriatricians
• Performing home visits and providing care through our unique Lifecare Planning program

Dedicated rotations in both the PGY-2 and PGY-3 years allow residents to train with our sports medicine physicians, orthopedists, podiatrists, and physical therapists evaluating musculoskeletal problems and procedures in their respective departments. In addition, residents may work with faculty physicians at local schools, attending games and performing pre-participation physical examinations.

Residents work in the Emergency Departments at both the Kaiser Permanente Vallejo and Vacaville Medical Centers. Within each center, residents work with both emergency and family medicine physicians. At Vacaville, residents also work in the new Level 2 trauma center and will participate as members of the trauma team.

We have recently rolled out a longitudinal Point-of-Care Ultrasound (POCUS) curriculum that incorporates three main components. The first is an annual hands-on training experience taught by ultrasound experts and utilizing live patients as an immersive experience to develop ultrasound skills. These sessions include two days of obstetrics and women’s health, a day of hospital medicine topics, and a day of musculoskeletal medicine topics. The second component is asynchronous learning experiences in ultrasound built into the curriculum longitudinally with topics focused on individual rotations, such as abdominal imaging during the surgery rotation. The third component is clinical training utilizing ultrasound in the Family Medicine Center, in the emergency department, in the hospital, and on rotations such as sports medicine.

Ultrasound Training – Obstetrics 1st Trimester

Ultrasound Training – Obstetrics 2nd 3rd Trimester

Ultrasound Training – Musculoskeletal

Ultrasound Training – Hospital Medicine

Over the three years of training, residents are exposed to a wide variety of practice management educational opportunities:

• Monthly Family Medicine Department Educational/Business Meetings
• Third year resident rotations as the Family Medicine Center Resident Team Leader
• Attendance at yearly regional workshops learning skills in leadership, physician-patient interaction skills, and team building
• Lectures on medical informatics
• Individualized information and training on achieving clinical goals in areas such as diabetes care, lipid management, and cancer screening
• Quality improvement projects under the guidance of faculty

Residents have a total of 16 weeks of elective time. Six weeks must be established electives within the medical subspecialties, while the remaining 10 weeks may be freely selected. Residents may also choose to participate in the Global Health Program as an elective.